Doctors missing infant violence warning signs

Updated
November 20, 2012 08:52:00

New research shows some signs of violence against children are being missed by doctors - and the chance to prevent repeat cases is being lost. It shows medical practicioners at a Sydney hospital didn't recognise subtle symptoms of maltreatment that were then linked to far more serious violence.

TONY EASTLEY: New research shows some warning signs of violence against children are being missed by doctors and the chance to prevent repeat cases is being lost as well.

It shows medical practitioners at a Sydney hospital didn't recognise subtle symptoms of maltreatment that were linked to far more serious violence.

The results are being outlined at a major emergency medicine conference in Hobart today, as Tom Nightingale reports.

TOM NIGHTINGALE: The consequences of shaking or hitting an infant can be permanent and horrific.

AMANDA STEPHENS: Almost every single child who suffers this will have a bad outcome.

TOM NIGHTINGALE: Doctor Amanda Stephens is a registrar at the Westmead Hospital in Sydney.

AMANDA STEPHENS: Now whether that means they die or whether that means they suffer a horrible neurological injury and they end up with developmental delay, they are going to have pretty much universally a bad outcome.

They're often injured in a small way to begin with, so if we can pick these cases up when they've occurred once rather than on multiple occasions, we can stop or at least minimise the really awful outcomes that occur.

TOM NIGHTINGALE: Doctor Stephens looked at 68 local cases of young children suffering inflicted head injuries. She found at least 12 showed signs of maltreatment, like facial bruising, at previous medical visits, but the seriousness of these wasn't recognised at the time.

AMANDA STEPHENS: I think partly its training. Doctors are not on the whole very well trained in issues of child protection. Even though training is meant to be mandatory, it doesn't always occur, and even when it does occur it can sometimes be a bit cursory.

TOM NIGHTINGALE: Why would training not occur, though?

AMANDA STEPHENS: Because I think sometimes doctors move around a lot.

TOM NIGHTINGALE: Doctor Steve Hambleton is the president of the Australian Medical Association.

STEVE HAMBLETON: Well certainly it's not surprising and child abuse is often misdiagnosed and under-recognised because often the presenting symptoms are quite subtle.

TOM NIGHTINGALE: He says determining the causes of the injuries is more difficult when repeat cases aren't seen by the same doctor. But he's not sure specifically what could be done about it.

STEVE HAMBLETON: I guess that's very difficult because the symptoms initially are so subtle, and when there are unusual symptoms that don't seem to make sense, always think about child abuse.

TOM NIGHTINGALE: Amanda Stephens says doctors and other health workers need to be more willing to ask tougher questions.

AMANDA STEPHENS: The first thing the parents come in with is 'This kid won't stop screaming', because a really, really important thing to get home to people is that if a parent is complaining about a child that won't stop screaming, you've got to actually take that seriously because that's the biggest trigger for carers to inflict these injuries.

TOM NIGHTINGALE: And do you think perhaps doctors aren't treating that sort of a complaint very seriously at the moment?

AMANDA STEPHENS: I think so, absolutely.

TOM NIGHTINGALE: The research is the first of its type in Australia. It's being presented today at the annual scientific meeting of the Australasian College for Emergency Medicine.